Source Of Diagnostic Information Research Articles

Pervasive Diagnosis

In model-based production, a planner uses a system description to create plans that achieve production goals. The same description can be used by model-based diagnosis to infer the condition of components from sensor data. When production is realized by a sequence of plans, prior work has demonstrated that diagnosis can be used to adapt the plans to compensate for component degradation. However, the sources of diagnostic information are severely limited. Diagnosis must either make inferences from observations during production over which it has no control (passive diagnosis), or production must be halted to introduce diagnostic-specific plans (explicit diagnosis). We observe that the declarative nature of the model-based approach allows the planner to achieve production goals in multiple ways. This flexibility is exploited by a novel paradigm, i.e., <i xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">pervasive (active) diagnosis</i> , which constructs <i xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">informative production plans</i> that simultaneously achieve production goals while uncovering additional diagnostic information about the condition of components. We present an efficient heuristic search for these informative production plans and show through experiments on a model of an industrial digital printing press that the theoretical increase in long-run productivity can be realized on practical real-time systems. We obtain higher long-run productivity than a decoupled combination of planning and diagnosis.

Trauma Patients Without a Trauma Diagnosis: The Data Gap at a Level One Trauma Center

Trauma registries may contain records without a codable trauma diagnosis, creating a "data gap" that multiplies the number of invalid registry data fields. We designed an investigation intended to determine the incidence of registry records with noncodable trauma diagnoses, characterize those records, and determine the reasons for inadequate diagnosis data. We used a retrospective cohort design. A query of trauma registry records spanning a 5-year period yielded 129 records with no injury severity score. Each patient's medical record was reviewed, sources of diagnostic information were noted, and diagnoses were categorized. In 57% of cases, we found documentation that the patient had sustained an injury, but the injury was inadequately documented in the discharge summary. In 19% of cases, although the registry record was valid, the diagnosis was not codable as trauma. In 17% of cases, clinical documentation was adequate, but the diagnosis was inadequately recorded in the trauma registry. In 13% of cases, no traumatic injury was sustained, although the registry record was valid. In 2% of cases, the trauma registry record itself was invalid. In 1% of cases, a coding error occurred. Particularly prominent among records with inadequate discharge documentation were cases of head and spine injury for which there was no radiographic evidence. The incidence of records with noncodable diagnoses might best be reduced through improved physician documentation, revision of trauma registry inclusion criteria, increased attention by trauma registrars to key sources of documentation, and direct communication with the attending physician when necessary.

Validating Diagnostic Information on the Minimum Data Set in Ontario Hospital-Based Long-Term Care

Over 20 countries currently use the Minimum Data Set Resident Assessment Instrument (MDS) in long-term care settings for care planning, policy, and research purposes. A full assessment of the quality of the diagnostic information recorded on the MDS is lacking. The primary goal of this study was to examine the quality of diagnostic coding on the MDS. Subjects for this study were admitted to Ontario Complex Continuing Care Hospitals (CCC) directly from acute hospitals between April 1, 1997 and March 31, 2005 (n = 80,664). Encrypted unique identifiers, common across acute and CCC administrative databases, were used to link administrative records for patients in the sample. After linkage, each resident had 2 sources of diagnostic information: the acute discharge abstract database and the MDS. Using the discharge abstract database as the reference standard, we calculated the sensitivity for each of 43 MDS diagnoses. Compared with primary diagnoses coded in acute care abstracts, 12 of 43 MDS diagnoses attained a sensitivity of at least 0.80, including 7 of the 10 diagnoses with the highest prevalence as an acute care primary diagnosis before CCC admission. Although the sensitivity was high for many of the most prevalent conditions, important diagnostic information is missed increasing the potential for suboptimal clinical care. Emphasis needs to be put on improving information flow across care settings during patient transitions. Researchers should exercise caution when using MDS diagnoses to identify patient populations, particularly those shown to have low sensitivity in this study.

Review of the literature on benzene exposure and leukemia subtypes

The epidemiologic literature on benzene exposure and leukemia in the MEDLINE and TOXNET databases was examined through October 2004 using the keywords “benzene”, “leukemia” and “adverse health effects”. This search was complemented by reviewing the reference lists from extant literature reviews and criteria documents on benzene. Published studies were characterized according to the type of industry studied and design, exposure assessment, disease classification, and control for confounding variables. Study design consisted of either cohort studies or case-control studies, which were further categorized into population-based and nested case-control studies. Disease classification considered the source of diagnostic information, whether there was clinical confirmation from medical records or histopathological, morphological and/or cytogenetic reviews, and as to whether the International Classification of Diseases (ICD) or the French–American–British (FAB) schemes were used (no studies used the Revised European–American Lymphoma (REAL) classification scheme). Nine cohort and 13 case-control studies met inclusion criteria for this review. High and significant acute myeloid leukemia risks with positive dose response relationships were identified across study designs, particularly in the “well-conducted” cohort studies and especially in more highly exposed workers in rubber, shoe, and paint industries. Risks for chronic lymphocytic leukemia (CLL) tended to show elevations in nested case-control studies, with possible dose response relationships in at least two of the three studies. However, cohort studies on CLL show no such risks. Data for chronic myeloid leukemia and acute lymphocytic leukemia are sparse and inconclusive.

Neurophysiological foundations of organ electrodermal diagnostics, acupuncture, TENS and other reflexive therapies

SummaryThe nervous system is the primary computing system of the human body. The sensory nervous system detects any damage done to the body from both outside and inside and sends the information, at the earliest stage of pathology, to the central nervous system (CNS), which controls potent self-defense mechanisms. The CNS cannot simultaneously process all available information, originating internally and externally, due to limited capacity. The necessity to eliminate information which is less important at the time, created the specific converging structure of the sensory nervous system. Due to this structure, signals sent from internal organs to the CNS can also reach certain skin areas influencing their electrical characteristics. In this way organ electrodermal diagnostics (OED) may get access to this ‘first hand’ source of diagnostic information. The CNS gives higher priority to signals resulting from external stimuli (skin) than to messages coming from internal organs: information coming from sensory ...

Electromagnetic flowmeters as a source of diagnostic information

Recent studies involving the analysis of process measurement signals have shown that the ‘noise’ components carry potentially useful diagnostic information not only regarding the operating conditions at the point of measurement but also regarding the status of the measurement system. This is particularly true if the primary sensor itself has a wide frequency response and the unconditioned signal is analysed. At first sight, it appears that electromagnetic flowmeters are particularly suitable in this respect because they are essentially non-invasive, their method of sensing does not influence the flow regime and they have no moving parts. However, because of the spurious signals which are developed at the electrodes, the measurement signal has to be obtained by modulating the magnetic field and synchronously demodulating the electrode signal, but this eliminates virtually all the ‘noise’ components of the original signal. For this study, this difficulty was circumvented by holding the excitation of the electromagnet constant for a brief period while the electrode signal was sampled. The ‘noise’ component in the sampled data was then separated from the other components by a high pass filter and analysed to provide diagnostic information regarding both the flow regime as well as the operational status of the associated process equipment. Unfortunately, this mode of operation precludes the ability of the flowmeter to measure the actual flow rate and, in any practical implementation of the concept, it would be necessary to arrange the signal processing system so that it operates in the conventional mode for the majority of the time, but is switched for a brief period to the alternative mode during which the ‘noise’ component of the electrode signal is gathered and then analysed to provide the diagnostic information.

Interpretation of basic gross pathologic changes of the digestive tract.

The necropsy is a valuable diagnostic tool. When presented with a dead animal, it is not uncommon for the necropsy to be the springboard for the entire diagnostic evaluation. Not only is important information gained from gross examination of the organs but during necropsy, tissue and fluid samples for supportive tests--bacterial culture, antibiotic sensitivity, virus isolation, serology, parasite burden, and toxicologic and histopathologic studies--are collected. It is not essential for a veterinarian to be a pathologist to get good information from a necropsy. This article attempted to identify a number of basic lesions that occur with the most common diseases of the digestive tract of food animals. Additionally, associations between lesions and certain etiologies as well as diseases have been made so that when one identifies a particular lesion (in a live or dead animal), a prioritized list of possible differential diagnoses comes to mind. The necropsy does not stand alone or above the other sources of diagnostic information. The information gained from a necropsy must be correlated with the other information to arrive at either a specific diagnosis or a short list of possible diagnoses. The veterinarian must seek further input, in the latter situation, from additional clinical examinations, laboratory tests, or interviews with the client to arrive at the diagnosis.

DSM-IV as an Information Resource in Rehabilitation Counseling

The DSM-IV is the most widely used source of diagnostic information pertaining to psychiatric disorders. The value of the DSM-IV in diagnosis, case management, and counselor education has been thoroughly documented. Despite the fact that psychiatric disabilities are represented in the field of vocational rehabilitation in growing numbers, applications of the DSM-IV in rehabilitation counseling have been slow to develop. This article illustrates important potential contributions of the DSM-IV in rehabilitation counseling, including conceptual structure for determining rehabilitation eligibility and needs, information necessary for diagnosis of co-existing disabilities, and insights into the developmental needs of consumers.

Analyzing Amenorrhea

When menarche has failed to occur or menstrual cycles have stopped, the problem can be traced back to a functional or structural defect in the hypothalamus, pituitary, ovaries, or uterus. In most cases, the history is the principal source of diagnostic information. Necessary laboratory studies include one for the most common cause of amenorrhea: pregnancy.

WISC Profiles in Child Psychiatric Diagnosis: Sense or Nonsense?

WISC factor structure, the specificity of WISC factors, and diagnostic correlates of WISC profiles were studied to investigate the contribution of WISC profile analysis to child psychiatric diagnosis. The fit of various factor models was tested and differences between various clinical groups regarding three WISC patterns were studied, using the WISC-RN (the Dutch version of the WISC-R) scores of a group of 465 Dutch children (mean age 11.2 years) referred to a psychiatric clinic. The traditional factor models were replicated in this study. However, most of the variance in the factors could be explained by an underlying factor, "general intelligence," suggesting that WISC factors measure specific cognitive abilities only to a limited degree. Another important finding is that the various DSM-III-R and Child Behavior Checklist diagnoses could not be distinguished on the basis of WISC profiles. The data demonstrate that the relationship between WISC factors and specific cognitive abilities and neuropsychological functions needs further clarification in order to improve the validity of the traditional use of WISC profiles as a source of diagnostic information.

Modeling human eye behavior during mammographic scanning: preliminary results

We investigate the use of an inexpensive and unobtrusive eye-tracking system to explore relationships between visual scanning patterns, pupillary response, and the clinical diagnoses of mammographic experts. One radiologist and three radiological technicians each examined a series of 14 mammograms for indications of abnormalities associated with breast cancer. The status of each mammogram was verified by biopsy. The eye-tracking system was used to measure and record eye position and pupil diameter as a function of time as the subjects scanned the mammograms. Three treatments were applied to the scan data to model the experts' eye behaviors. These included quantification of dwell time and pupil diameter as a function diagnostic accuracy in regions of the mammogram where abnormalities existed or were perceived; independent clustering of lookpoints without respect to abnormalities; and analysis of scan transitions between lookpoint clusters. Results of the analysis were consistent with extensive prior studies of eye-scan measures recorded during the diagnosis of abnormalities on chest radiograms. This preliminary investigation provides a proof of concept for use of the eye-tracking technology, experimental protocols, and analysis methodologies as the basis for expanded mammographic studies, with the promise of eventual adaptation as a source of diagnostic information in clinical practice.

Up Against the Wall: Psychometrics Meets Praxis

In this article, two school administrators argue that care must be taken to fit the specifics of a testing program to Its intended purpose. Specifically, they argue that the purposes of testing for diagnosing individual student teaming and for school evaluation should not be confused. They suggest that while typical systemwide testing programs may provide useful evaluative information, they suffer from several characteristics that make them hardly useful as sources of diagnostic information for guiding instruction in individual teachers' classes.

Computerized Endodontic Diagnosis

TJL he differential diagnosis of pulpal disease involves a complex analysis of clinical data. This diagnosis can be dif­ ficult to make because of conflicting or insufficient data or a lack of experience. In these instances, consultation between clinicians is often helpful. However, time, finances, and other constraints often prevent such a consultation. The need for an alternate, readily available source of diagnostic information is ap­ parent. More than 20 years ago, it was recog­ nized that a computer’s ability to store and process data offered a possibility of analyzing and interpreting symptoms with increased accuracy. Computer pro­ grams in the areas of congenital heart dis­ ease,1 thyroid disease,2 and glaucoma3 provided diagnostic accuracy compara­ ble with that of an experienced specialist. Early attempts to model the diagnostic process were based on conditional prob­ abilities. This approach remains useful for any area in which records are available to formulate accurate probability tables that summarize the relationship between symptoms and diseases.4 Sixty percent of 58 existing medical diagnostic programs have used this approach.5 Because accurate probability tables cannot always be derived from existing data, other mathematical approaches have been developed. An example of an alternative approach is the rule-based system, designed around textbook data and personal experience and not directly dependent on historical data.6,7 This type of program is typically developed in one of the artificial intelligence languages, such as list processing language (LISP),8 on a large computer system. Computers have been used in dentistry for a number of years. Applications have encompassed such diverse areas as computer-assisted instruction (CAI),912 cardiopulmonary resuscitation (CPR) training,13 standardized patient chart­ ing,14 19 and practice and clinic manage­ ment.20-34 Computers have also been used to collect, store, and analyze data in many phases of dental research.35'42 Diagnostic applications have primarily focused on orthodontic diagnosis.43'52 Early dental applications were neces­ sarily based on the large university com­ puter systems. More recently, micro­ computer applications are being de­ scribed with increasing frequency. Com­ mercial computer services, programs, and systems for private practice man­ agement are widely available and are frequently discussed in the lite ra ­ ture.24'27’29-31'34 Developments in micro­ computer dental diagnostic programs should be of increasing interest to the clinician because of the current availabil­ ity of the relatively low-cost (under $5,000) microcomputer in the dental of­ fice. This study investigates the possibility of designing a prototype interactive microcomputer program for the purpose of assisting in the diagnosis of “pulpally involved” teeth.

Comparison of Base Metal Alloys and Type IV Gold Alloys for Removable Partial Denture Frameworks

The advantages and disadvantages of chromium cobalt-nickel alloys and Type IV gold alloys have been discussed and the indications for each enumerated. The metal of choice should be the decision of the dentist, based on the finding available from the various sources of diagnostic information. In the final analysis the choice should be the one that will allow the performance of the best oral health service.